Fri Nov 29 2024

112 articles - From Friday Nov 22 2024 to Friday Nov 29 2024

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Guidelines

Guidelines and related publications, position statements, white papers, technical reviews, consensus statements, etc…

Gastroenterology

AGA Living Clinical Practice Guideline on Pharmacological Management of Moderate-to-Severe Ulcerative Colitis.

This guideline provides a comprehensive, patient-centered approach to the pharmacological management of patients with moderate-to-severe UC.

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J Hepatol

Metabolic Dysfunction and Alcohol-related Liver Disease (MetALD): Position statement by an expert panel on alcohol-related liver disease.

Additionally, metabolic dysfunction and alcohol use should be reassessed over time, especially after periods of changes in risk factor exposure. This approach could ensure a more accurate prognosis and effective management of SLD addressing both metabolic and alcohol-related factors.

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Meta-analysis

meta-analyses and systematic reviews

Am J Gastroenterol

Global Prevalence and Clinical Manifestations of Celiac Disease Among First-Degree Relatives: A Systematic Review and Meta-Analysis.

Approximately 1 in 14 FDRs of CeD patients is estimated to have CeD, with 1 in 4 daughters, 1 in 7 sisters, 1 in 11 brothers, 1 in 16 sons, and 1 in 20 fathers and mothers could be affected. Routine screening for FDRs could support early detection and management of CeD.

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Endoscopy

Safety and efficacy of lumen-apposing metal stents for endoscopic ultrasound-guided drainage of pancreatic fluid collections: a systematic review and meta-analysis.

Our study shows good technical and clinical success rates with al three LAMSs for EUS-guided PFC drainage. Total AEs and bleeding were highest with the Axios stent and lowest with the Spaxus. Stent migration was highest with the Nagi stent and lowest with the Spaxus.

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Gastrointest Endosc

Endoscopic Submucosal Tunneling Techniques versus Flexible Endoscopic Septotomy for Zenker's Diverticulum: A Systematic Review and Meta-Analysis.

ESTT demonstrated a higher probability of clinical success and showed a trend toward a lower recurrence rate compared to FES; however, both groups had similar technical success, operative time, length of hospital stay, and overall adverse events. These findings underscore ESTT as an effective and safe method for treating patients with ZD.

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J Hepatol

Histological severity, clinical outcomes and impact of antiviral treatment in indeterminate phase of chronic hepatitis B: a systematic review and meta-analysis.

Patients in the indeterminate phase are at risk of developing advanced liver disease and HCC. Although inherent heterogeneity across studies limited the evidence to support expanding treatment to al patients in the indeterminate phase, antiviral therapy may reduce the risk of HCC development in high-risk subgroups. Impact and implications Current international guidelines recommend close monitoring and evaluation of patients with chronic hepatitis B (CHB) in the indeterminate phase, and not al of these patients are indicated for antiviral treatment. Based on the systematic review and meta-analysis with significant heterogeneity across studies, patients in the indeterminate phase are at risk of developing hepatocellular carcinoma (HCC), cirrhosis, and hepatic decompensation. Meta-regression findings on platelet count, positive HBeAg, and age highlighted the importance of liver fibrosis assessment, accurate phase classification, and timely detection of phase transition to identify antiviral treatment indications, supporting current guideline recommendations. Antiviral treatment may reduce risk of HCC in the high-risk subgroups of patients in the indeterminate phase. Prospero registration number CRD42024537095.

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Original articles

RCT, clinical trials, retrospective studies, etc…

Aliment Pharmacol Ther

Comparative Efficacy and Safety of Three Janus Kinase Inhibitors in Ulcerative Colitis: A Real-World Multicentre Study in Japan.

Considering the particularly high efficacy of upadacitinib, even in patients with refractory UC, filgotinib or tofacitinib may be considered as an upfront JAK inhibitor before using upadacitinib.

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Coronary Artery Disease and Major Adverse Cardiovascular Events in People With Hepatic Steatosis at Low Atherosclerotic Cardiovascular Disease Risk.

Individuals with HS at ASCVD < 7.5% risk had similar CAD characteristics as patients without HS at < 7.5% ASCVD risk, yet experienced comparable MACE rates as those at ASCVD ≥ 7.5%.

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Hepatic Events During Immune Checkpoint Inhibitor Treatment Between Liver and Non-Liver Malignancies in Hepatitis B Endemic Areas.

Under ICI treatment, HCC patients had a higher risk of hepatitis flare events than non-HCC patients. Abnormal baseline ALT levels are a risk factor for hepatic adverse events. NUC prophylaxis can minimise the risk of HBVr.

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Impact of Nonalcoholic Fatty Liver Disease on the Survival of People Living With HIV.

For PLWH, advanced liver fibrosis increases the risk of overall death and liver-related death. LSM and the FAST score are similar predictors of survival for PLWH with potential for NAFLD.

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Serum Ferritin Levels and Liver-Related Events in Individuals With Steatotic Liver Disease: A Longitudinal Cohort Study.

Serum ferritin levels correlated with the risk of LRE in patients with SLD.

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Am J Gastroenterol

A Phase II, multicentric, randomized, double-blind, placebo controlled, proof of concept study of efficacy and safety of Rifamycin SV-MMX® 600 mg tablets administered three or two times daily to patients with diarrhea-predominant irritable bowel syndrome (IBS-D).

Rifamycin SV-MMX® 600mg b.i.d. was more effective than placebo and t.i.d. dosing in the first week of treatment. Two months following treatment, Rifamycin SV-MMX® 600mg b.i.d. provided more global symptom relief than placebo.

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Burden of Digestive Diseases in the United States Population: Rates and Trends.

is substantial, particularly among Blacks and older adults. Further research is needed to better understand reasons for disparities and trends in health care use and mortality reported in this paper.

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Dietary intake and quality in irritable bowel syndrome: a comparative study with controls and the association with symptom severity.

Patients with IBS exhibit different dietary patterns compared to controls, with poorer dietary habits linked to more severe symptoms. Understanding food-symptom associations may enhance the optimization and personalization of dietary management for IBS patients.

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Orthodontic rubber band traction improves trainees' learning curve of colorectal endoscopic submucosal dissection: a prospective randomized study.

ORB-ESD shortened colorectal ESD procedure time and improved efficiency in trainees to an expert level. ORB-ESD could shorten the learning curve, justifying its widespread application.

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PERSISTENCE, EFFECTIVENESS, AND SAFETY OF UPADACITINIB IN CROHN'S DISEASE AND ULCERATIVE COLITIS IN REAL LIFE: RESULTS FROM A SPANISH NATIONWIDE STUDY (UREAL STUDY): Upadacitinib for IBD.

Upadacitinib is effective and safe for treating highly refractory IBD patients, even in previously treated with JAK inhibitors.

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Practical Application of the COuGH RefluX Score for Patients with Laryngopharyngeal Symptoms: Real-World Assessment in Predicting GERD and PPI Response.

The COuGH RefluX score is effective in predicting GERD and guiding PPI use in LPS patients without esophagitis. The score can ensure appropriate PPI use and targeted testing during initial LPS patient encounters.

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Prospective controlled study of endoscopic botulinum toxin injection for retrograde cricopharyngeus dysfunction, the inability to belch syndrome.

HRM with carbonated drink provocation demonstrates pathognomonic signs of R-CPD that were not seen in health. Flexible endoscopic cricopharyngeal botulinum toxin injection is highly effective for symptomatic relief compared to no treatment.

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Seasonal Patterns in Eosinophilic Esophagitis-Related Emergency Department Visits: A National Database Analysis.

Seasonal dietary habits and social behaviors likely contribute to EoE exacerbations. Healthcare providers should emphasize management strategies during high-risk periods, particularly summer months and weekends.

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Sex differences in patient-reported outcomes and perception of ascites burden amongst outpatients with decompensated cirrhosis and ascites.: Sex Differences in Ascites Burden Perception.

Women with cirrhosis and ascites experienced worse emotional HRQoL than men without difference in daily function. Our analyses underscore the differences in the lived experience of women versus men with cirrhosis and highlight the need for patient-reported metrics to provide patient-centered care.

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Use of a Two-gene Methylated DNA Biomarker Assay and Non-Endoscopic Balloon for Detection of Barrett's Esophagus among High-Risk Individuals in a Screening Population.

This study in the intended-use population suggests that EG/EC is promising for BE screening. While future work is necessary to define its performance characteristics with more precision, this approach may provide a safe, accurate, and well-tolerated non-endoscopic alternative in high-risk patients.

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Clin Gastroenterol Hepatol

Older age but not comorbidity is associated with worse survival in patients with hepatocellular carcinoma.

Older age but not comorbidity burden is associated with worse survival in patients with early-stage HCC. Further studies are needed to define the role of comorbidity in HCC prognostication.

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Prognostic Communication, Symptom Burden, Psychological Distress, and Quality of Life Among Patients with Decompensated Cirrhosis.

While most patients with DC highly valued prognostic communication, the majority reported never discussing their end-of-life care preferences with their hepatologists. Self-reported terminally ill health status and inadequate prognostic communication were associated with poorer symptoms, mood, and HRQOL. Interventions to improve prognostic communication while simultaneously providing adequate supportive care are warranted.

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Endosc Int Open

Advances and challenges in endoscopy training: A mixed methods study among endoscopy trainers in the Netherlands.

Considerable variability in endoscopy training practices between gastroenterology teaching hospitals was identified. Formal education on endoscopy teaching, promotion of self-regulated learning, and standardization of endoscopy training programs and supervision practices have the potential to improve future endoscopy training.

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Areas of improvement for colorectal cancer screening: Results of a screening initiative for 10,000 health care employees in Austria.

There is a serious gap between recommended standards and real-world CRC screening colonoscopy quality. Implementation of CRC screening should not only be accompanied by strategies to increase participation rates but focus on implementation of rigorous, mandatory colonoscopy quality assurance programs.

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Digital peroral pancreatoscopy to determine surgery for patients who have intraductal papillary mucinous neoplasms of the pancreas with mural nodules.

POPS-DS could be used to accurately detect malignancy in patients with MN-positive IPMN. Therefore, histocytological evaluation using POPS-DS can contribute to selection of patients for whom surgery would be appropriate.

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Dye-based chromoendoscopy versus i-scan virtual chromoendoscopy in long-standing ulcerative colitis: Multicenter prospective RCT.

However, use of i-scan VCE was associated with a lower false-positive rate and a significantly shorter procedure time compared with DCE. I-scan VCE, therefore, could be a valid replacement for DCE in UC surveillance colonoscopies.

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Enteroscopy-assisted ERCP in patients with surgically altered anatomy: Multicenter prospective registry (SAMISEN-B) using motorized spiral enteroscopy.

(clinicaltrials. gov: NCT05129449).

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Evaluating endoscopic ultrasound-guided tissue acquisition for diagnosis of small pancreatic neuroendocrine neoplasms.

EUS-TA showed adequate diagnostic sensitivity and grading agreement for p-NENs of al sizes, allowing for determination of appropriate treatment.

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Feasibility and benefit of decompressive percutaneous endoscopic gastrostomy (dPEG) in advanced cancer patients with malignant bowel obstruction.

However, the technical success rate is limited and needs to be improved. Prospective studies comparing endoscopic and computed tomography-guided procedures are needed to avoid unsuccessful procedures in patients with advanced cancer and limited life expectancy.

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Feasibility of newly designed rotatable sphincterotome for endoscopic sphincterotomy (with video).

We evaluated the feasibility of the newly designed r-sphincterotome using an experimental model. We believe that the findings from these experiments may contribute to easier and more precise sphincterotomies.

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Intraoperative bleeding model for swine gastric endoscopic submucosal dissection via heparinization.

High doses of heparin significantly increased intraoperative bleeding and hematoma during swine ESD.

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Low incidence of deep vein thrombosis after double-balloon endoscopy and colorectal submucosal dissection: Multicenter, prospective study.

This prospective study demonstrated that risk of DVT/PE following highly invasive endoscopic procedures including colorectal ESD and DBE is very low.

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Which is the better polyp detection metric: adenomas per colonoscopy or adenoma detection rate? A simulation modeling study.

Adjusting for patient and exam factors and/or using shrinkage techniques for lower-volume endoscopists can increase the correlation between TEA for both ADR and APC. For higher detection rates, APC offers more power than ADR in distinguishing differences in detection ability.

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Gastroenterology

A pan-genotypic hepatitis E virus replication inhibitor with high potency in a rat infection model.

JNJ-9117 has a profile that holds promise for the treatment of life-threatening HEV infections in humans. Phase 1 studies with JNJ-9117 have been initiated in healthy human volunteers.

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Preclinical protein signatures of Crohn's disease and ulcerative colitis: A nested case-control study within large population-based cohorts.

We identified protein signatures for predicting a future diagnosis of CD and UC, validated across independent cohorts. In the context of CD, the signature offers potential for early prediction.

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Gastrointest Endosc

A randomized controlled trial of a through the scope stiffening wire to increase the depth of insertion during double balloon enteroscopy.

The stiffening wire increased insertion depth and should be used when an abnormality cannot be reached with conventional technique.

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Creating a Standardized Tool for the Evaluation and Comparison of Artificial Intelligence-Based Computer-Aided Detection Programs in Colonoscopy: a Modified Delphi Approach.

This is the first reported international consensus statement of priority scoring metrics for CADe in colonoscopy. These scoring criteria should inform CADe software development and refinement. Future research should validate these metrics on a benchmark video data set to develop a validated scoring instrument.

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Necrosectomy and its timing in relation to clinical outcomes of endoscopic ultrasound-guided treatment of walled-off pancreatic necrosis: a multicenter study.

In the EN-treated patients, the timing of EN was not statistically significantly associated with the time to clinical success (P = 0.34) CONCLUSION: Among patients receiving EUS-guided treatment of symptomatic WON, the use of EN in addition to drainage procedures was associated with earlier disease resolution. Further research is desired to determine the optimal timing of initiating EN considering a risk-benefit balance and cost-effectiveness.

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Stratification of risk for lymph node metastasis and long-term oncologic outcomes in patients initially treated by endoscopic resection for rectal neuroendocrine tumors.

The risk of LN metastasis increased significantly when the number of risk factors increased in patients with rectal NETs. Patients who initially underwent endoscopic resection for rectal NETs showed a favorable long-term oncologic outcome if salvage treatments were performed, depending on the stratification of their risk factors.

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Gut

Divergent lineage trajectories and genetic landscapes in human gastric intestinal metaplasia organoids associated with early neoplastic progression.

Overall, our IMO biobank captured the heterogeneous nature of IM, revealing mechanistic insights on IM pathogenesis and progression, offering an ideal platform for studying early gastric neoplastic transformation and chemoprevention.

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Genetic variation at 11q23.1 confers colorectal cancer risk by dysregulation of colonic tuft cell transcriptional activator <i>POU2AF2</i>.

Background Common genetic variation at 11q23.1 is associated with colorectal cancer (CRC) risk, exerting local expression quantitative trait locus (cis-eQTL) effects on is the primary transcriptional activator of tuft cells with a tumour suppressive role in mouse models. We therefore implicate tuft cells as having a key tumour-protective role in the large bowel epithelium.

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Spatial dissection of tumour microenvironments in gastric cancers reveals the immunosuppressive crosstalk between <i>CCL2+</i> fibroblasts and <i>STAT3</i>-activated macrophages.

Cell type-specific transcriptional dynamics revealed that malignant and endothelial cells promote the cellular proliferations of TME cells, whereas the fibroblasts and immune cells are associated with procancer and anticancer immunity, respectively. Ligand-receptor analysis revealed that -activated macrophages plays roles in establishing immune-suppressive GC TME with potential clinical relevance.

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Top-down infliximab plus azathioprine versus azathioprine alone in patients with acute severe ulcerative colitis responsive to intravenous steroids: a parallel, open-label randomised controlled trial, the ACTIVE trial.

29 adverse events were severe, including 13 disease exacerbations, 6 severe infections without any difference between both arms. Interpretation Combination therapy with IFX+AZA was more effective at 1 year than AZA alone to avoid treatment failure in patients with ASUC responding to intravenous steroids.

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Hepatology

Human T cells engineered with an HLA-A2-restricted murine T-cell receptor targeting Glypican 3 effectively control human hepatocellular carcinoma in mice.

Transgenic TCRs join forces with CARs, expanding the arsenal of GPC3-targeting receptors for HCC T-cell therapy.

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Medical treatment of primary sclerosing cholangitis: What have we learned and where are we going?

Despite the lack of consensus for an ideal phase II and phase III study design, several trials for diverse compounds are currently ongoing, indicating a shift from therapeutic nihilism towards hope for people with PSC. While waiting for robust efficacy data for drugs currently being tested, the current lack of effective interventions should not motivate prescription of compounds to people with PSC based on low-quality evidence.

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J Hepatol

Real-world clinical data-driven modelling on the initiation time of antiviral prophylaxis among pregnant women with chronic hepatitis B infection.

Physicians can determine when to begin antiviral prophylaxis for those women according to their maternal HBV DNA levels. Our findings justify the initiation time of antiviral prophylaxis recommended by the Chinese guidelines and will offer new insights for other international guidelines.

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Reviews&Editorials

Plenty of the editorials are available as full text through the publisher website using the provided link

Aliment Pharmacol Ther

Editorial: Allostatic Load and Inflammatory Bowel Disease.

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Editorial: Is TIPSS Implantation Effective in Patients With Portal Hypertensive Gastropathy?

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Editorial: Metabolic Dysfunction and Alcohol-Two Sides of the Same Coin.

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Clin Gastroenterol Hepatol

Blue Notes.

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Gender Inequity in Pharma-Supported Inflammatory Bowel Disease Presentations: Shining a Light on Opportunities for Equality and Transparency in Medical Research.

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Endosc Int Open

How should the electrosurgical mode be optimized for endoscopic sphincterotomy?

Pubmed   Journal   ReadQx   PMC

Gut

Recent advances in incretin-based therapy for MASLD: from single to dual or triple incretin receptor agonists.

In this narrative review, we examine the rapidly expanding body of clinical evidence supporting a role of incretin-based pharmacotherapies in delaying or reversing MASH progression. We also discuss the biology of incretins and the putative hepatoprotective mechanisms of incretin-based pharmacotherapies for managing MASLD or MASH.

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J Hepatol

Towards more consistent models and consensual terminology in preclinical research for Steatotic Liver Disease.

While implementing these improvements presents logistical challenges, doing so is essential to enhancing the translational relevance and reproducibility of animal studies, and advancing therapeutic discoveries. Furthermore, we address the persisting inconsistency in terminology used in animal studies and propose clinically meaningful terms that can be applied consistently to preclinical research.

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Miscellaneous

misc publications eg case reports, tools of the trade, images of the month, etc…

Am J Gastroenterol

Intussusception Due to Infectious Enteritis in an Adult Treated with Endoscopic Reduction.

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Judicious Use of Antibiotics in Liver Transplant Recipients Undergoing Endoscopic Retrograde Cholangiopancreatography.

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Endoscopy

"The future of GI endoscopy…where are we going?"

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Assessment methods for senior resident attainment based on a new training model.

Pubmed   Journal   ReadQx   PMC

Barrett's early cancer. Should we abandon piecemeal resections?

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Biliary cannulation of a peridiverticular papilla using multiloop traction in a patient with Roux-en-Y anatomy.

Pubmed   Journal   ReadQx   PMC

Bringing light into darkness: peroral double-balloon enteroscopy-guided endoscopic injection sclerotherapy for a jejunal hemangioma.

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Cholecystohepaticogastrostomy: novel endoscopic gallbladder drainage technique to prevent acute cholecystitis following endoscopic ultrasound-guided biliary drainage.

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Colonoscopy preparation adequacy in glucagon-like peptide-1 receptor agonist users: the jury is still out.

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Combined endoscopic submucosal dissection and endoscopic laryngopharyngeal surgery for an oropharyngeal lesion extending to the flap of a glossopharyngeal reconstruction.

Pubmed   Journal   ReadQx   PMC

Endoluminal single-clip traction-assisted endoscopic submucosal dissection: a green tip to reduce waste and cost.

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Endoscopy E-Videos - recently published.

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Exploring artificial intelligence-assisted diagnosis of esophageal squamous cell carcinoma: insights from a clinical trial.

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Master-apprentice technique for improved learning of endoscopic closure of defects using the reopenable clip-over-line method.

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Modified NOTES technique for creation of an endoscopic gastrojejunostomy.

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Modified endoscopic hand-suturing without scope reinsertion for an ileocecal defect after endoscopic submucosal dissection.

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Over-the-scope pre-looping method using an endoloop in endoscopic full-thickness resection of gastric gastrointestinal stromal tumor.

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Prophylactic saline-immersion snare-tip vessel coagulation after colorectal endoscopic resection.

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Reverse cannulation and dilation successfully assist the cannulation of the accessory pancreatic duct.

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Successful biliary biopsy in a patient with surgically altered anatomy using a slim peroral cholangioscope via an endoscopic ultrasound-guided biliary drainage fistula.

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Successful closure of a duodenal stump leak with an over-the-scope clip using double-balloon endoscope.

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Successful endoscopic sphincterotomy using a novel rotatable sphincterotome in a patient with Roux-en-Y gastrectomy.

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Successful endoscopic ultrasound-guided drainage using contrast-enhanced harmonic imaging.

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Unexpectedly detected appendiceal perforation during endoscopic direct appendicitis therapy despite negative preoperative computed tomography imaging.

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Unlicensed stent use creating the need for additional procedures.

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Gastroenterology

An Unusual Cause of Diarrhea and Hematochezia.

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Better Together: Implementing a Multidisciplinary Approach to Optimizing Diagnosis and Management of Crohn's Perianal Fistulas.

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Gender Inequity in Pharma-Supported Inflammatory Bowel Disease Presentations: Shining a Light on Opportunities for Equality and Transparency in Medical Research.

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Liver Transplantation for Colorectal Cancer Metastasis: An Evolving Option With Hope in Selected Patients.

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Prevalence of Pediatric Inflammatory Bowel Disease in the United States: Pooled Estimates from Three Administrative Claims Data Sources.

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Gastrointest Endosc

A rare atypical Idiopathic Mesenteric Phlebosclerosis( original text: IMP) characterized by widespread submucosal bulges of small bowel and colon: first report.

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Abdominal sarcoma mimicking an ectopic pregnancy.

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Endoscopic submucosal dissection for a squamous cell carcinoma of the soft palate and uvula (with video).

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Rescue Laparoscopy-Assisted Repositioning of a Misdeployed Metal Stent in the Peritoneum Following Endoscopic Ultrasound-Guided Hepaticogastrostomy (with video).

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Hepatology

Cover Image.

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Hepatology Highlights.

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Instructions to Authors.

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Table of contents.

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Letters&Replies

Letters to the editors and authors’ replies

Aliment Pharmacol Ther

Editorial: Allostatic Load and Inflammatory Bowel Disease. Authors' Reply.

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Letter: Combination Therapies With Vitamin E for Metabolic Dysfunction-Associated Steatotic Liver Disease.

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Letter: Critical Insights on a Nationwide Cohort Study of Inflammatory Bowel Disease, Histological Activity and Fracture Risk.

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Letter: Integrating Psychological Profiles Into Dietary Interventions for IBS-Commentary on HADS Scores and Treatment Efficacy.

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Letter: Towards Better Intervention Strategies for MASLD and MetALD-What Are We Missing?

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Letter: Towards Better Intervention Strategies for MASLD and MetALD-What Are We Missing? Authors' Reply.

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Letter: Using non-invasive fibrosis tests and emerging diagnostics to enhance the accuracy of liver fibrosis staging in MASLD patients.

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Letter: Why Assessment of ChILI Severity Accurately Matters?

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Gastroenterology

Optimizing CT-P13 SC Use in IBD: ADA Formation, Comparative Efficacy, and Dose Adjustment Strategies.

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PDO-Based Drug Screening in Advanced Pancreatic Cancer: Addressing Predictive Value and Broader Clinical Implications.

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Gut

Sphincterotomy with FCSEMS (SPHINX): a monumental answer or the beginning of new mysteries?

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J Hepatol

Evaluating Fracture Risk with TDF in Elderly Hepatitis B Patients: A Korean Perspective.

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Exploring the effects of serum G-CSF levels in acute-on-chronic liver failure (ACLF): Insights from a post-hoc analysis of the GRAFT study.

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Human albumin administration at the time of large volume paracentesis: a modified Delphi study.

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MASH Meets HBV: Age, Lifestyle, and the Untapped Role of Non-Immune Cells.

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PLEX for Acute Liver Failure in UK National Cohort: A situation perplexed!

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Plasma exchange for acute liver failure in a real-world cohort: what it was and should have never been.

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Poor long-term outcome in patients with porto-sinusoidal vascular disease (PSVD): fact or disease misclassification?

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Response to Letter to Editor: Communicating the complexity of the transplant benefit score.

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